Which of the following classes of drugs shall be strictly avoided with Methylene Blue? [Select ALL THAT APPLY].

a. SSRIs
b. Penicillin Antibiotics
c. Triazole antifungal agents
d. Calcium channel blockers
e. SNRIs

Which of the following classes of drugs shall be strictly avoided with Methylene Blue? [Select ALL THAT APPLY].

a. SSRIs
b. Penicillin Antibiotics
c. Triazole antifungal agents
d. Calcium channel blockers
e. SNRIs

Answer: (a,e). FDA has issued two safety communications regarding adverse drug reactions in patients taking certain psychiatric medications, and also given methylene blue or linezolid (Zyvox). Specifically, FDA has received reports of serious central nervous system reactions in patients taking serotonergic psychiatric medications (SSRIs or SNRIs) who are also given methylene blue, a product commonly used in diagnostic procedures. FDA explains that "although the exact mechanism of this drug interaction is unknown, methylene blue inhibits the action of monoamine oxidase A - an enzyme responsible for breaking down serotonin in the brain.

It is believed that when methylene blue is given to patients taking serotonergic psychiatric medications, high levels of serotonin can build up in the brain, causing toxicity. This is referred to as Serotonin Syndrome.

Signs and symptoms of Serotonin Syndrome include mental changes (confusion, hyperactivity, memory problems), muscle twitching, excessive sweating, shivering or shaking, diarrhea, trouble with coordination, and/or fever.

Similar reports of interactions between certain serotonergic psychiatric medications and the antibacterial drug, Linezolid (Zyvox) have also been reported to FDA.

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Which of the following drugs may cause hyperchloremic acidosis?

a. Nitrofurantoin
b. Amlodipine
c. Zonisamide
d. Capecitabine
e. Adalimumab

Which of the following drugs may cause hyperchloremic acidosis?

a. Nitrofurantoin
b. Amlodipine
c. Zonisamide
d. Capecitabine
e. Adalimumab

Answer: (c). Zonisamide (Zonegran)is an antiseizure drug chemically classified as a sulfonamide and unrelated to other antiseizure agents. It is supplied for oral administration as capsules containing 25 mg or 100 mg Zonisamide.

Zonisamide is indicated as adjunctive therapy in the treatment of partial seizures in adults with epilepsy. It can be taken with or without food. The initial dose of ZONEGRAN should be 100 mg daily. After two weeks, the dose may be increased to 200 mg/day for at least two weeks. It can be increased to 300 mg/day and 400 mg/day, with the dose stable for at least two weeks to achieve steady state at each level. Evidence from controlled trials suggests that Zonegran doses of 100-600 mg/day are effective, but there is no suggestion of increasing response above 400 mg/day.

Zonisamide causes hyperchloremic, non-anion gap, metabolic acidosis (i.e., decreased serum bicarbonate below the normal reference range in the absence of chronic respiratory alkalosis).This metabolic acidosis is caused by renal bicarbonate loss due to the inhibitory effect of zonisamide on carbonic anhydrase.

Generally, Zonisamide-induced metabolic acidosis occurs early in treatment, but it can develop at any time during treatment. Metabolic acidosis generally appears to be dose-dependent and can occur at doses as low as 25 mg daily.

Conditions or therapies that predispose to acidosis (such as renal disease, severe respiratory disorders, status epilepticus, diarrhea, ketogenic diet, or specific drugs) may be additive to the bicarbonate lowering effects of zonisamide.

Some manifestations of acute or chronic metabolic acidosis include hyperventilation, nonspecific symptoms such as fatigue and anorexia, or more severe sequelae including cardiac arrhythmias or stupor. Chronic, untreated, metabolic acidosis may increase the risk for nephrolithiasis or nephrocalcinosis.

Somnolence, anorexia, dizziness, ataxia, agitation/irritability, and difficulty with memory and/or concentration are also reported side effects of Zonisamide.

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U.S. Health Coalition message: "Double Check, Don't Double Up" is in reference to which of the following?

a. Acetaminophen
b. Digoxin
c. Levothyroxine
d. Oxycodone

Answer: 

U.S. Health Coalition message: "Double Check, Don't Double Up" is in reference to which of the following?

a. Acetaminophen
b. Digoxin
c. Levothyroxine
d. Oxycodone

Answer: Acetaminophen. The Acetaminophen Awareness Coalition is launching a nationwide initiative today calling on consumers to double check their medicine labels so they don't double up on medicines that contain acetaminophen during the cold and flu season. Acetaminophen is the most common drug ingredient in America. It is found in more than 600 different medicines, including prescription (Rx) and over-the-counter (OTC) pain relievers, fever reducers, sleep aids and numerous cough, cold and flu medicines. It is safe and effective when used as directed, but there is a limit to how much can be taken in one day. Taking more than directed is an overdose and can lead to liver damage.

Each year, Americans catch an estimated one billion colds, and as many as 20 percent get the flu. Seven in 10 consumers use over-the-counter medicines, many of which contain acetaminophen, to treat their symptoms. The Coalition is targeting its "Double Check, Don't Double Up" message to the more than 50 million Americans who use acetaminophen weekly for conditions such as headache and chronic pain, and directing them to double check their medicine labels before taking a cold or flu medicine that also contains acetaminophen.

When taking medicines for cough, cold or flu this coming season, consumers should follow these four simple acetaminophen safety steps:

1. Know if medicines contain acetaminophen, which is in bold type or highlighted in the "active ingredients" section of over-the-counter medicine labels and sometimes listed as "APAP" or "acetam" on prescription labels.
2. Never take two medicines that contain acetaminophen at the same time.
3. Always read and follow the medicine label.
4. Ask your healthcare provider or a pharmacist if you have questions about dosing instructions or medicines that contain acetaminophen.

In a patient taking Erythromycin, the dose of Livalo should be restricted to:
 
a. 1 mg per day.
b. 5 mg per day.
c. 10 mg per day.
d. 25 mg per day.
e. 50 mg per day.

In a patient taking Erythromycin, the dose of Livalo should be restricted to:
 
a. 1 mg per day.
b. 5 mg per day.
c. 10 mg per day.
d. 25 mg per day.
e. 50 mg per day.
 
Answer: a. Pitavastatin (Livalo) is an inhibitor of HMG-CoA reductase. It is a synthetic lipid-lowering agent for oral administration. Each film-coated tablet of Pitavastatin (Livalo) contains1 mg. 2 mg or 4 mg Pitavastatin.
 
It is indicated as an adjunctive therapy to diet to reduce elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), triglycerides (TG), and to increase HDL-C in adult patients with primary hyperlipidemia or mixed dyslipidemia.
 
Doses of Pitavastatin (Livalo) greater than 4 mg once daily were associated with an increased risk for severe myopathy in premarketing clinical studies. PAtients should not exceed 4 mg once daily dosing of Pitavastatin (Livalo). The dose range for Pitavastatin (Livalo) is 1 to 4 mg orally once daily at any time of the day with or without food. The recommended starting dose is 2 mg and the maximum dose is 4 mg.
 
In patients taking erythromycin, a dose of Pitavastatin (Livalo) 1 mg once daily should not be exceeded. In patients taking rifampin, a dose of Pitavastatin (Livalo) 2 mg once daily should not be exceeded.
 
Rhabdomyolysis with myoglobinuria and acute renal failure and myopathy (including myositis) and liver enzyme abnormalities are principal side effects of Pitavastatin (Livalo).
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Ofirmev, available as an injection, is an antipyretic and non-opioid analgesic agent. Which of the following is an active ingredient found in it?
 
a. Acetaminophen
b. Ibuprofen
c. Tramadol
d. Aspirin
e. Pregabalin

Ofirmev, available as an injection, is an antipyretic and non-opioid analgesic agent. Which of the following is an active ingredient found in it?
 
a. Acetaminophen
b. Ibuprofen
c. Tramadol
d. Aspirin
e. Pregabalin
 
Answer: a
 
Acetaminophen (Ofirmev) is a non-salicylate antipyretic and non-opioid analgesic agent in injection dosage form. It is indicated for:

1. the management of mild to moderate pain;
2. the management of moderate to severe pain with adjunctive opioid analgesics;
3. the reduction of fever.
 
Acetaminophen (Ofirmev) may be given as a single or repeated dose for the treatment of acute pain or fever. No dose adjustment is required when converting between oral acetaminophen and Acetaminophen (Ofirmev) dosing in adults and adolescents. The maximum daily dose of acetaminophen is based on all routes of administration (i.e. intravenous, oral, and rectal) and all products containing acetaminophen.
 
Adults and adolescents weighing 50 kg and over: the recommended dosage of Acetaminophen (Ofirmev) is 1000 mg every 6 hours or 650 mg every 4 hours, with a maximum single dose of Acetaminophen (Ofirmev) of 1000 mg, a minimum dosing interval of 4 hours, and a maximum daily dose of acetaminophen of 4000 mg per day.
 
Adults and adolescents weighing under 50 kg: the recommended dosage of Acetaminophen (Ofirmev) is 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours, with a maximum single dose of Acetaminophen (Ofirmev) of 15 mg/kg, a minimum dosing interval of 4 hours, and a maximum daily dose of acetaminophen of 75 mg/kg per day.

Nymalize, a calcium channel blocker, is indicated for which of the following?
 
a. Hypertension
b. Arrhythmia
c. Parkinson's
d. Subarachnoid hemorrhage
e. Depression

Nymalize, a calcium channel blocker, is indicated for which of the following?
 
a. Hypertension
b. Arrhythmia
c. Parkinson's
d. Subarachnoid hemorrhage
e. Depression

Answer:d.

Nymalize contains Nimodipine, a dihydropyridine calcium channel blocker. An oral solution of Nymalize contains 60 mg of Nimodipine per 20 mL.

It is indicated for the improvement of neurological outcome by reducing the incidence and severity of ischemic deficits in adult patients with subarachnoid hemorrhage (SAH) from ruptured intracranial berry aneurysms regardless of their post-ictus neurological condition (i.e., Hunt and Hess Grades I-V).

The recommended oral dosage is 20 mL (60 mg) every 4 hours for 21 consecutive days.

Hypotension is the major side effect of Nymalize.

Khedezla is indicated for the treatment of which of the following?...

Khedezla is indicated for the treatment of which of the following?

a. Hypertension
b. Depression
c. Arthritis
d. Type II diabetes
e. Parkinsons

Answer: (b) Depression

The active ingredient found in Khedezla is Desvenlafaxine. Desvenlafaxine (O-desmethylvenlafaxine) is the major active metabolite of the antidepressant Effexor (Venlafaxine), a medication used to treat major depressive disorder.
 
Khedezla contains the serotonin and norepinephrine reuptake inhibitor (SNRI) Desvenlafaxine, which is also contained in Pristiq. Pristiq was approved by the FDA in 2008 and contains Desvenlafaxine as the succinate salt.
 
Khedezla will be available in 50 mg and 100 mg strengths for once daily administration. The recommended dose for Khedezla is 50 mg once daily, with or without food. It should be taken at approximately the same time each day. Tablets must be swallowed whole with fluid and not divided, crushed, chewed, or dissolved.
 
In clinical studies, doses of 50 mg to 400 mg per day were shown to be effective, although no additional benefit was demonstrated at doses greater than 50 mg per day and adverse reactions and discontinuations were more frequent at higher doses.
 
Nausea, dizziness, insomnia, hyperhidrosis (excessive sweating), constipation, drowsiness, decreased appetite, anxiety, and specific male sexual function disorders are commonly reported side effects of the drug.
 

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WARNING!

Please be aware of the scam, originally brought to our attention by one of our customer.This company website URL is rx-exam.com. The website phone number is 123-456-7890 - which itself suggests it is a fraud.They are claiming to sell materials from their websites for various pharmacy related exams. All materials are offered for online purchase. Many customers have lost their money since after purchasing using credit cards; they don't receive any material.

PleaseDO NOT PURCHASEany material from this sitewww.rx-exam.com.

PharmacyExam (RxExam) is not affiliated with this company and bears no responsibility for any financial loss. Please pass this message to your friends. The authenticated web site for our company iswww.pharmacyexam.com

Thank you.

Founder and President

Manan Shroff

Test 3

Test 3

Veklury must be administered:

a. IV infusion
b. Subcutaneously
c. Intramuscularly
d. Orally
e. Rectally

Veklury must be administered:

a. IV infusion
b. Subcutaneously
c. Intramuscularly
d. Orally
e. Rectally

Answer: (a). The active ingredient found in Veklury is Remdesivir. Veklury (Remdesivir) is authorized for use under an Emergency Use Authorization (EUA) only for the treatment of adult and pediatric patients hospitalized with suspected or laboratory-confirmed COVID-19, and for whom use of an intravenous (IV) agent is clinically appropriate. Veklury must be administered via IV infusion. It is only administered intravenously in a hospital setting under the care of a physician.

Remdesivir is an adenosine nucleotide prodrug that distributes into cells where it is metabolized to form the pharmacologically active nucleoside triphosphate metabolite. Metabolism of Remdesivir to Remdesivir triphosphate has been demonstrated in multiple cell types. Remdesivir triphosphate acts as an analog of adenosine triphosphate (ATP) and competes with the natural ATP substrate for incorporation into nascent RNA chains by the SARS-CoV-2 RNA-dependent RNA polymerase, which results in delayed chain termination during replication of the viral RNA. Remdesivir triphosphate is a weak inhibitor of mammalian DNA and RNA polymerases with low potential for mitochondrial toxicity.

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